Empowerment of women and their family in rural community

The incidence of maternal and child death is highest in 75 countries in south East Asia and Africa. The most critical contributing factor is the awareness levels of women, families and communities about the potential negative consequences associated with delayed seeking of maternal and child health care (MCH). The two-way communication tool, the MCH Handbook, is recommended to enhance MCH knowledge, practice and continuum of care.

The MCH Handbook is a health promotion tool that equips mothers and families with record-keeping guides and accessible information. A multi-country study showed that the introduction of the MCH Handbook was an effective tool for accelerating mother's and family's awareness and utilisation of community clinics. MCH Handbooks are distributed at no cost, and mothers are encouraged to keep this booklet for reference at home and at each clinic visit.

An estimated 63% of pregnant women do not receive any antenatal, postnatal or delivery services from medical facilities. Various studies have shown that handbooks assist, encourage and empower pregnant mothers to seek needed care and to inform them as to when, where and how to obtain that care. By providing health promotion information from pregnancy until the child is 6 years old, handbooks also help ensure continuity of care.

The MCH Handbook applies a two-way communication model for promoting awareness of MCH services, while exiting tools in Bangladesh are largely one-way (such as treatment cards, EPI cards, antenatal cards etc). There is no evidence to suggest that these cards are effective or being properly used by mothers. A pilot study conducted in Bangladesh revealed that the MCH Handbook is a good starting point and an effective community-based tool for promoting maternal, neonatal and child health. The MCH Handbook will help reduce delays in decision-making at the family level, as well as delays in arranging quality services at the facility level.

The writer is an Assistant Professor at the University of Toronto. E-mail: shafi.bhuiyan@utoronto.ca